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Hyperpigmentation on the background of rosacea: modern methods of treatment

Hyperpigmentation and rosacea are very common diseases that are visible to people from far away and difficult to mask cosmetic skin defects.

The mechanism of hyperpigmentation and rosacea
The basis of the formation of hyperpigmentation is a violation of the processes of melanogenesis. The causes of hyperpigmentation are associated with injuries, inflammatory processes (acne), photodamage of the skin, hormonal changes, gastrointestinal problems and other sources.

The basis of the appearance of rosacea is a violation of the microcirculation processes of the skin: first, blood stagnation occurs in the surface capillary network, this leads to its expansion, later, due to constant loads, the vascular wall loses its elasticity, becomes brittle and thin, as a result of which the pathological process becomes more common.

The main causes of rosacea are smoking, photodamage of the skin (“lovers of tanned skin”), stress, hormonal disorders, gastrointestinal problems and other factors.

The combination of hyperpigmentation and rosacea in clinical practice is very common. The main provoking factor is photodamage (insolation), as well as inflammation (acne) and injuries received after aggressive cosmetic procedures. The clinical picture is very simple: first, temporary local redness appears on the skin of the face, later persistent hyperemia with dilated vessels (telangiectasias) is localized in these areas. In the future, without treatment, the pathological process will only worsen.

Methods of treatment of rosacea and hyperpigmentation
Modern methods of aesthetic correction can eliminate hyperpigmentation and spider veins without side effects. Currently, the following methods are used to remove visible dilated vessels:

electrocoagulation (cauterization of telangiectasia with a hair electrode);
radio wave coagulation (cauterization of blood vessels by radio waves);
ozone therapy (“gluing” a vessel using an ozone-oxygen mixture);
vascular sclerosis (“soldering” of a vessel with a sclerosing agent).
These methods are invasive, that is, they violate the skin, respectively, a short rehabilitation period is needed, since after the procedures crusts and hematomas of various degrees of severity are formed.

Modern methods of treatment of rosacea
At the moment, light is considered the most promising treatment for rosacea, since they minimally change the skin after the procedure and regress it quickly enough.

Light treatment methods include phototherapy and laser therapy. Let’s consider them in more detail.

Phototherapy – treatment (coagulation) of dilated blood vessels using a flash of pulsed light. This method is non-invasive (without damage to the skin), does not require a rehabilitation period.

Laser therapy, namely a neodymium laser Nd: Yap 1064 nm. The energy of light with a wavelength of 1064 nm penetrates to a depth of 8 mm and coagulates deep vessels up to 2 … 4 mm in diameter. Immediately after treatment, the blood vessel darkens, which indicates its coagulation.

A distinctive feature of this method is its selectivity: not the entire area of ​​exposure is heated, but only the blood vessels themselves, respectively, the risk of side effects (scarring, overheating of surrounding tissues) is excluded. The procedure itself lasts several minutes. After the procedure, minor hyperemia persists, passing within 2 hours. In the following days, the treated vessel turns pale and disappears. The number of procedures in the course depends on the severity of the pathological process (from 1 to 3 procedures).

Modern treatments for hyperpigmentation
The main goal of modern techniques that are used to remove hyperpigmentation is the destruction of skin cells containing a large amount of melanin. Currently, the following methods are used in cosmetology:

chemical peels, dermabrasion (exfoliation of the upper layer of the skin);
mesotherapy whitening cocktails (suppression of melanin production);
These methods do not completely solve the problem of hyperpigmentation, the pigment is partially preserved, moreover, after traumatic procedures (dermabrasion), pigmentation can be enhanced due to post-traumatic stimulation of melanogenesis.

Laser therapy to treat hyperpigmentation
At present, phototherapy and laser therapy are considered the most effective treatments for hyperpigmentation. These methods are based on selective photothermolysis – the selective destruction of cells that contain an excessive amount of melanin, as a result of which hyperpigmentation is completely removed.

Our clinic uses a universal method of treating hyperpigmentation and rosacea – AFT therapy. A Harmony XL laser device (manufactured by AlmaLasers, Israel) with an AFT 570-950 nm nozzle minimizes the impact on surrounding tissues and makes the procedure as safe and predictable as possible.

The applied wavelengths (570-950 nm) are absorbed not only by hemoglobin, but also by melanin.

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